Articles: low-back-pain.
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The choice of medication for low back pain should be evidence based and tailored as much as possible to suit the individual patient. Acetaminophen (paracetamol), mild opioids and NSAIDs are the first-line drugs for low back pain but there is no evidence that one is more effective than the others. ⋯ The realization that symptoms other than pain are sometimes more important and/or easier to overcome can increase the benefits of medication. The long-term effects of medication can be improved when it is combined with non-drug interventions.
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Clinical Trial
Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests.
Previous research indicates that physical examination cannot diagnose sacroiliac joint (SIJ) pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. This study examined the diagnostic power of pain provocation SIJ tests singly and in various combinations, in relation to an accepted criterion standard. ⋯ In conclusion, composites of provocation SIJ tests are of value in clinical diagnosis of symptomatic SIJ. Three or more out of six tests or any two of four selected tests have the best predictive power in relation to results of intra-articular anaesthetic block injections. When all six provocation tests do not provoke familiar pain, the SIJ can be ruled out as a source of current LBP.
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Comparative Study
Beliefs about low back pain in the Norwegian general population: are they related to pain experiences and health professionals?
A baseline study of the general population and the health care providers in 3 Norwegian counties. ⋯ Belief in spontaneous recovery from LBP seems to be positively correlated to previous experience with LBP without current pain. Patients of the various health care providers seem to have a faith in spontaneous recovery similar to that of their health care provider. These differences may frustrate the public and patients who visit more than one provider, and hinder collaboration among professional groups.
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To evaluate whether a perceived decline in the level of physical activity after the onset of pain (PAD) is more appropriate in the explanation of disability as compared to the actual level of physical activity (PAL) in patients with sub-acute back pain. ⋯ The perceived decline in physical activity, rather than the current physical activity itself is important in the evaluation of the impact of activity related changes on disability in low back pain.
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Multicenter Study Comparative Study
The transition from acute to subacute and chronic low back pain: a study based on determinants of quality of life and prediction of chronic disability.
Follow-up study. ⋯ LBP influences disability and quality of life more than RP. Disability is predicted by pain duration and quality of life is predicted by disability, but pain severity predicts neither one of them. Changes related to determinants of disability and quality of life, and to the prediction of chronic disability, appear 14 days after the onset of pain, supporting that cutoff point for considering a patient as being subacute.